Dopamine Nation: Finding Balance in the Age of Indulgence

Cigarette smokers are more likely than matched controls to discount monetary rewards (that is, they value them less if they have to wait longer for them). The more they smoke, and the more nicotine they consume, the more they discount future rewards.

As one patient put it, “With disulfiram, I only need to decide once a day not to drink. I don’t have to keep deciding all day long.”

Some people, most commonly East Asians, have a genetic mutation that causes them to have a disulfiram-like reaction to alcohol without the drug. These individuals have historically had lower rates of alcohol addiction.

Dopamine is not the only neurotransmitter involved in reward processing, but most neuroscientists agree it is among the most important. Dopamine may play a bigger role in the motivation to get a reward than the pleasure of the reward itself. Wanting more than liking . Genetically engineered mice unable to make dopamine will not seek out food, and w

A study of skydivers compared to a control group (rowers) found that repeat skydivers were more likely to experience anhedonia, a lack of joy, in the rest of their lives.

The authors wrote that “skydiving has similarities with addictive behaviors and that frequent exposure to ‘natural high’ experiences is related to anhedonia.”

The brain encodes long-term memories of reward and their associated cues by changing the shape and size of dopamine-producing neurons. For example, the dendrites, the branches off the neuron, become longer and more numerous in response to high-dopamine rewards. This process is called experience-dependent plasticity . These brain changes can last a

The ancient Greeks developed a heating system for public baths but continued to advocate for the use of cold water to treat a variety of ailments. In the 1920s, a German farmer named Vincenz Priessnitz promoted the use of ice-cold water to cure all manner of physical and psychological disorders. He went so far as to turn his home into a sanitarium

With repeated exposure to the same or similar pleasure stimulus, the initial deviation to the side of pleasure gets weaker and shorter and the after-response to the side of pain gets stronger and longer, a process scientists call neuroadaptation .

In today’s dopamine-rich ecosystem, we’ve all become primed for immediate gratification. We want to buy something, and the next day it shows up on our doorstep. We want to know something, and the next second the answer appears on our screen. Are we losing the knack of puzzling things out, or being frustrated while we search for the answer, or havin

My patient Jasmine came to me seeking help for excessive alcohol consumption, up to ten beers every day. As part of the treatment, I advised her to remove all alcohol from her home as a self-binding strategy. She mostly took my advice, with a twist.

She removed all alcohol save one beer, which she left in her refrigerator. She called it her “totemic